Provider Demographics
NPI:1366659757
Name:DAVID LEE MARTIN, M.D., P.A.
Entity Type:Organization
Organization Name:DAVID LEE MARTIN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-258-2500
Mailing Address - Street 1:12411 HYMEADOW DR
Mailing Address - Street 2:BUILDING 3, SUITE A
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-1874
Mailing Address - Country:US
Mailing Address - Phone:512-258-2500
Mailing Address - Fax:
Practice Address - Street 1:12411 HYMEADOW DR
Practice Address - Street 2:BUILDING 3, SUITE A
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1874
Practice Address - Country:US
Practice Address - Phone:512-258-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care